What is Arthritis?

An estimated 1 in 5 British Columbian adults has some form of arthritis, and many don’t even know it.

There are more than 100 different types of arthritis, a disease that affects people of all ages, from babies, prime of life, to older people. Contrary to popular belief, it is not a disease of the elderly; in fact, more than 3 in 5 people diagnosed with arthritis are under the age of 65. The disease affects all people, though some people — like women and Aboriginal Canadians — are more likely to get arthritis than others.

More than 6 million Canadians live with arthritis that falls into two major groups:

Osteoarthritis - Caused by a breakdown of cartilage in joints causing bones to rub together resulting in pain, stiffness and eventual loss of use. There are some forms of osteoarthritis that appear to be genetically driven, and others that are a result of injury, overuse or advanced age.

In British Columbia, approximately 615,000 people – or 1 in 7 – are living with osteoarthritis (OA). Within one generation (30 years) it is anticipated that 1 in 4 or 1.49 million British Columbians will be living with OA and one person in British Columbia will be diagnosed every 8.8 minutes.

Inflammatory arthritis - is a general term used to describe autoimmune forms of the disease. In inflammatory arthritis, the body's own immune system attacks healthy joints and tissues, causing inflammation and joint damage. Rheumatoid arthritis is the most common form of inflammatory arthritis. Other forms include ankylosing spondylitis, psoriatic arthritis, lupus and many others.

Unlike OA, rheumatoid arthritis (RA) can occur at any age. In 2010, approximately 40,000 people in British Columbia were living with RA. The prevalence of RA is expected to rise by 80 per cent by 2030. In 2040, more than 80,000 people– or 1 in 71 people in British Columbia – will be living with RA; one person in British Columbia will be diagnosed with RA every 2.6 hours.

Treatment Options

British Columbians living with arthritis have a variety of therapy options to treat their disease. Medication treatments can be divided into two categories: 1) those that control symptoms; and 2) those that control the disease itself. Non-medication treatments, such as healthy eating, exercise and physical therapy, should also be considered with your healthcare provider. In addition to managing physical symptoms of arthritis, it is also important for individuals to take care of their mental health. Mental health is just as important as physical health, and it is not uncommon for people living with arthritis and chronic pain to feel depressed, anxious or helpless. Under resources for symptom management, you will find credible links to help you better manage your mental health.

Medication Treatments

For many people living with arthritis, medications are a critical part of their treatment plan. While there are no known cures for arthritis, many effective treatments exist, especially for inflammatory forms of arthritis. These medications can, in some cases, actually stop the disease process that causes joint damage and disability. With the advent of new medication treatments, arthritis patients and their health care providers have an expanded range of options available to them when making decisions about a treatment plan.

Until the mid 1980s, arthritis treatment options (both medication and non-medication) were scarce. Often, doctors would take a slow approach to treatment, putting patients on pain-relievers like acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) for long periods of time before trying more aggressive treatments.

We now know that in many forms of inflammatory arthritis, there is a "window of opportunity" at the beginning of the disease process when appropriate treatment can actually stop the progression of the disease and prevent joint damage and disability.

Today, the approach to the treatment of arthritis, particularly for inflammatory arthritis, has changed. Instead of having patients struggle on a medication that simply provides pain relief, doctors, backed by scientific evidence, have started to treat patients early and aggressively, with the goal to reduce medications if the patient goes into remission.

Life style changes – such as recreational and therapeutic exercise – are very important for all stages of osteoarthritis. In part, because currently there are no medications found effective at treating the underlying disease process. For example, recent research has shown that weight loss in people living with knee osteoarthritis who are overweight significantly decreased their pain, increased their knee joint function, and ultimately, improved their quality of life. In other words, exercise is often the best medicine to treat the most common type of osteoarthritis.

Essentially, there are two categories of medications. It should be noted that the medications in the second category, those that treat the underlying disease process, are used only in some forms of inflammatory arthritis. For osteoarthritis, there are currently no medications proven to treat the underlying disease, only medications in the first category, those that treat the symptoms associated with the disease.

Medication Guides

Medication guides enable people living with arthritis to have a meaningful conversation with their rheumatologist and pharmacist about available therapy options and route of administration. The information in medication guides is not intended to suggest a course of treatment. It is for information only. Always speak to your healthcare provider before starting a medication.

Click below to find a chart outlining many of the medications used to treat arthritis.

Non-medication treatments:

In addition to medications, a well-rounded treatment plan for arthritis includes several important components. Taking control of your disease means making sure your body is as healthy and strong as possible. This means eating well, making sure you get enough of the right vitamins and minerals, maintaining a healthy body weight, quitting smoking, doing the right kinds of exercise, and making your home and work environments as supportive and accessible as possible.

Physiotherapy

Occupational therapy

Exercise

Diet and nutrition

Vitamins and minerals

Smoking cessation

Sleep and fatigue

Stress reduction

Surgery:

In some cases, where medication and non-medication treatments have been ineffective, a doctor may recommend surgery to relieve pain and increase joint function. Surgery is most common in severe cases of osteoarthritis (although it can also occur due to inflammatory arthritis), and is usually performed on the hip or knee(s). To learn more about the risks and benefits of surgery, what to expect, and how to prepare, visit one of the following surgery resources:

Resources

The ArthritisBC+Me portal provides a list of websites on a wide variety of arthritis topics.

We have selected and evaluated these websites and apps, but cannot guarantee the function, accuracy or currency of the websites and apps and the information contained within them.

Inclusion/ Removal Policy

The websites and apps listed in this section have been chosen by our community partners, with input from our scientific advisors, regarding websites or apps that contain technical or scientific information. Although suggestions of websites and apps for inclusion are welcomed, the ArthritisBC+Me portal retains the final decision on which websites will be included.

Sites and apps included in the Websites and Apps section are reviewed on a regular basis. The ArthritisBC+Me portal considers the following criteria when evaluating websites and apps, but may include websites or apps that do not meet all of the criteria if they are considered useful to arthritis patients.

Inclusion Criteria

provides information that is relevant to arthritis patients

provides accurate and reliable information

clearly identifies the sources of information on its site

identifies its mandate, scope, and objectives

identifies its sources of funding and sponsorship

exists primarily for informational or educational purposes and not to promote a product or service

identifies the author or responsible organization and provides information about their credentials

provides a way to contact the author, organization, or webmaster

provides information that is reasonably current and is reviewed and updated regularly

is well organized and easy to use

provides unique information that is not easily found elsewhere

Removal Criteria

is out of date and is no longer maintained

contains numerous defunct links

is found to contain inaccurate or misleading information is replaced by another site that provides superior coverage on the same topic

is replaced by another site that provides superior coverage on the same topic

The ArthritisBC+Me portal provides a list of websites on a wide variety of arthritis topics.
We have selected and evaluated these websites and apps, but cannot guarantee the function...

FAQ

As a patient, care giver or healthcare professional, you may have questions about how to find help for people living with arthritis in BC. This FAQ section contains questions frequently asked by BC arthritis patients.

1 How do you recognize symptoms of arthritis?

There are more than 100 different types of arthritis and symptoms vary widely between each type. For example, primary symptoms range from pain, stiffness and swelling in joints for rheumatoid arthritis, to dryness of the eyes and mouth for Sjögren’s Syndrome, to spiking fevers and a faint, salmon coloured rash over certain areas of the body for adult-onset Stills disease.

For many types of arthritis, however, there are common signs (things your doctor can see, like a swollen joint) and symptoms (things patients feel, like fatigue, pain, etc.) that point the way towards a specific arthritis diagnosis. While these symptoms may differ among types of arthritis, there are several which are commonly associated with inflammatory arthritis and osteoarthritis. For a full list of disease-specific signs and symptoms, see disease spotlights here:

2 What do you do if you recognize symptoms of arthritis?

If you are experiencing symptoms such as joint stiffness and pain or fatigue, it is important to speak with your doctor about them. Early detection, diagnosis and treatment are vitally important when dealing with almost every type of arthritis. A correct diagnosis is the first step a person with arthritis can make towards taking control of their disease and taking action in building a treatment plan. Click here to access a system assessor:

3 How do you get a referral to an arthritis specialist?

If your family doctor suspects you have osteoarthritis, in all but serious cases, your osteoarthritis will be managed by your family doctor. The Osteoarthritis (OA) Tool will be a helpful resource. The OA Tool has been developed for primary care providers who are managing patients with new or recurrent joint pain consistent with OA in the hip, knee or hand.

A rheumatologist is a doctor who specializes in treating arthritis. In British Columbia, a referral from a family doctor is required to see a rheumatologist.

Rheumatologists specialize in the management of inflammatory types of arthritis such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. These specialists have at least five years of additional training, on top of their regular medical schooling.

It can be challenging to get a referral from a family doctor to a rheumatologist. This may be because there are so many forms of arthritis, and general practitioners may not be familiar with many of the symptoms of the more than 100 different types of arthritis.

There are some things you can do to make it easier to get a referral to a rheumatologist. First, tell your doctor if you have the hallmark symptoms of inflammatory arthritis. These are:

Ongoing joint pain and swelling

Ongoing morning stiffness, lasting more than an hour after rising

Inability to continue daily work and living activities.

Also, tell your doctor about any history of inflammatory arthritis in your family, as some forms of the disease may have a genetic component.

Once your family doctor suspects inflammatory arthritis, he or she will need to write you a referral letter. This letter should include the following:

The suspected diagnosis of inflammatory arthritis.

A brief history and clinical findings. These may include morning stiffness, weight changes, fever patterns, and number and types of joints affected.

Copies of all reports, including MRIs, x-rays, and letters from any other specialists consulted.

If your family doctor suspects you have osteoarthritis, in all but serious cases, your osteoarthritis will be managed by your family doctor. The Osteoarthritis (OA) Tool will be a helpful resource. The OA Tool has been developed for primary care providers who are managing patients with new or recurrent joint pain consistent with OA in the hip, knee or hand.

4 How important are diet and nutrition in managing my arthritis?

What you eat can help you manage your arthritis or make your pain worse. Certain foods have been shown to provide some inflammation relief, strengthen bones and boost the immune system. The most important role diet and nutrition plays is helping attain or maintain ideal body weight, achieve good heart health, and promote or manage diabetes and osteoporosis. As a potential member of your healthcare team, a registered dietician can help you design and follow an “arthritis friendly” diet. You can find information about dietitian services in BC here: https://www.healthlinkbc.ca/dietitian-services

5 What lifestyle changes should I consider to help manage my arthritis?

Once arthritis is diagnosed, finding the right medication is often key. Once the right treatment has been identified and started, many people living with arthritis will often regain enough of their health to make lifestyle changes to reduce the pain and disability associated with their disease.

In addition to diet and nutrition, exercising at this point in a treatment program is crucial, as it helps to prevent weight-gain and muscle loss. Even moderate physical activity can help to improve health outcomes. Light cardiovascular and weight-bearing exercise, as well as low-impact water-aerobics are examples of exercises to help you regain fitness and keep your muscles toned to support healthy joints. Even periods of high intensity exercise can be beneficial as long as joints are protected and rest periods are included.

Studies show that smoking is one of the strongest environmental risk factors for developing rheumatoid arthritis. For those diagnosed with rheumatoid arthritis, smoking decreases the effectiveness of drugs prescribed to treat the disease and can be a barrier to engaging in activities that may relieve symptoms of rheumatoid arthritis, such as exercise.

6 Who provides arthritis programs and services in your community?

These are some of the services and service providers you might interact with to practice prevention and treatment strategies.

Publicly-funded arthritis treatment programs

The following are publicly-funded arthritis treatment programs that offer clinics and classes free of charge to help people with osteoarthritis and inflammatory arthritis manage their disease. All of these programs require a physician referral, so talk to your doctor if you would like to be referred:

Additional programs located in your community may be found on the Health Link BC website: www.Healthlinkbc.ca

Arthritis Consumer Experts

Arthritis Consumer Experts provides free, science-based information and education programs to people with arthritis. ACE serves people living with all forms of arthritis by helping them take control of their disease and improve their quality of life through education and empowerment.

HealthLink BC

HealthLink BC provides access to non-emergency health information and advice in British Columbia. Information and advice is available by telephone, a website, a mobile app, and a collection of print resources, including the BC HealthGuide Handbook.

HealthLink BC’s registered dietitians offer telephone, email and web-based based food and nutrition services to support the information, education and counselling needs of B.C. residents and health professionals.

QuitNow

QuitNow is the free, quit-smoking program of the Government of British Columbia, delivered by the BC Lung Association.

7 How can I volunteer in the arthritis community in BC?

We encourage you to get involved in arthritis community activities in BC. Please go to arthritis community partner websites to learn more about volunteer opportunities:

8 How can I donate to arthritis in BC?

Your donation is important to those affected by arthritis and to Canadian researchers who continue to look for a cure. Please go to these organizations to find out how you can support British Columbians living with arthritis: